Organization
FAMILY FARE, LLC
Active
Other names
D AND W PHARMACY 1570
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
1116 ROBBINS RD, GRAND HAVEN, MI 49417-2740
(616) 846-7180
(616) 846-1176
Mailing address
1527 MOMENTUM PL, SPARTAN PHARMACY NORTH, CHICAGO, IL 60689-5315
(616) 878-8584
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008228
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841359940
NPI
MI
01
—
2368973
NCPDP
MI
01
—
2368973
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
4963213
MI-DME
MI
Enumeration date
12/06/2006
Last updated
12/07/2023
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